The Gut Paradox: Could Digestive Health be the Root Cause of Most Health Problems Ranging from Hormone Issues, Autoimmune Disorders and Even Cancer?

Dr. Steve Burlison is a functional health practitioner, board-certified chiropractor, and keynote speaker. He has also been a patient. You see his health one day started to break down and he develop an autoimmune disorder. It started as a small rash — tiny red spots on his legs and arms. It was itchy but he felt it would surely go away, not giving it much thought, and thinking perhaps this was some sort of allergic or stress reaction. Over time it got worse. Much worse. He started to be in constant pain, with red inflamed skin that looked and felt so bad that you would think he had second degree burns all over his body. The burning, swelling, and itchiness reached excruciatingly painful levels. The unbearable symptoms started to greatly impact his life. Yes, after leading what he considered a full, healthy and vigorous life, this skin condition, or whatever it was, had spread throughout his entire body and had completely taken over his life.It was this experience that changed his perception of health forever. This book is his story of how he got his health and life back and how you can also overcome your own health change buy healing your gut.

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Contents
Introduction
We Have A Problem
A Functional Medicine Approach
Hope Is The Start To Healing
Healing Starts In The Gut
Hormone Balance And Gut Health
Gut Health And Autoimmune Disease
Cell And Digestive Detoxing
Quick Strat To Healing Your Gut
A Healthy Gut Thru Stress Management
28 Day Detox Plan
Recipes For Your 28 Day Cleanse
NOTES
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Lunchtime Or Dinner Recipes
Super Burger
2 pounds grass-fed ground beef
¼ cup organic mustard
½ cup drained organic sauerkraut
½ a white organic onion, sliced
Himalayan sea salt to taste
Step 1. Heat grill to medium-high. Form the beef into four ¾-inch-thick patties. Season with salt.
Step 2. Cook the patties to medium temperature.
Step 3. Use the lettuce leaves as the “sandwich buns” and add the burgers, onion, watercress, mustard, and sauerkraut.
Chicken and Salsa-Stuffed Avocados
4 servings
1 lb shredded or ground chicken
1⁄2 cup red onion, diced
4 radishes, diced
4 avocados, cut in half with pit removed
1⁄4 cup fresh cilantro leaves, chopped finely
1 tbsp lime juice
Pinch salt
Step1 Dice red onion, cilantro, and radishes. Add to medium bowl with juice of one lime and a dash of salt.
Step 2 Add shredded cooked chicken to the bowl and toss to combine.
Step 3 Halve the avocados and remove pits. Spoon a large scoop of the chicken-salsa mixture into each avocado half.
Enjoy immediately.
Crusted Salmon
2 wild caught salmon fillets (6oz each)
2 tbs coconut flour
2 tbs parsley
1 tablespoon olive oil
1 tablespoon dijon mustard
salt and pepper, to taste
Step 1 Preheat oven to 450 degrees.
Step 2 Place salmon fillets on a parchment paper.
Step 3 Top your salmon off with olive oil and dijon mustard and rub into your salmon.
Step 4 Mix coconut flour, parsley, and salt and pepper.
Step 5 Use a spoon to sprinkle on your toppings on your salmon and then your hand to pat into your salmon.
Step 6 Place in oven for 10-15 minutes or until salmon is cooked to your preference. I cooked mine more on the medium rare side at 12 minutes.
Step 7 While the salmon is cooking, mix your salad ingredients.
Step 8 When salmon is done, place salmon on top of salad and consume.
Coconut Chicken Curry
4 servings
1 Tbsp olive oil
2 cloves garlic chopped
1 onion diced
1 sweet potato peeled and chopped into 1/2 inch cubes
1/2 cup green onions chopped
2 stalks celery chopped
1 organic chicken breast cooked and cut into bite-sized pieces
1/2 Tbsp turmeric
1/2 Tbsp cumin
1 Tbsp coriander
1/2 tsp onion powder
1 tsp salt
1 13.5 oz can full-fat coconut milk
1 avocado sliced
THAI COCONUT chicken or turkey SOUP
4 Servings
2 cup shredded cooked turkey (or chicken) meat
1 onion, sliced thin
1 Handful of shiitake mushrooms, cut in half
3 cloves of garlic, finely minced
1-inch piece of ginger, julienned
4 cups Bone broth (can substitute organic chicken stock)
½ cup canned coconut milk
1½ tablespoons red Thai curry paste*
1 bell pepper
2 handfuls of chopped carrots
Salt to taste
A small handful of cilantro
4 to 6 drops of liquid Stevia
Step 1 Heat coconut oil in a large pot over medium, heat. Add onions and carrots cook till they begin to soften. Add shiitake mushrooms and cook for about 5 minutes, or until they are soft. Add garlic, ginger and cook for 1 more minute.
Step 2 Add bone broth or substitute organic chicken stock, turkey or chicken meat, coconut milk, good quality curry paste. Bring to a boil then reduce to a simmer for 2 minutes.
Step 3 Remove from heat and add bell pepper and sprouts.
Strep 4 Taste and add salt and liquid Stevia as necessary.
Carrot Fries
4 Serving
1 1/2 lb carrots, cut into thick matchsticks
2 tbsp coconut oil
1 tsp ground coriander
1⁄2 tsp salt
STEP 1 Heat oven to 400° F.
STEP 2 On a large baking sheet, toss the cut carrots in the oil, then sprinkle with salt and ground coriander.
STEP 3 Roast until golden brown and tender, about 30 minutes. Flip carrots once or twice while cooking.
Dr. Toni’s Home Made “Pizza”
Serves 4
1 lb ground bison
3 tbsp coconut flour 1 tbsp garlic powder
1 tbsp onion powder
1 tbsp dried basil
1 tsp sea salt
1 small white onion, thinly sliced
2 tbsp kalamata olive tapenade
(optional, omit if on SIBO or Candida Protocols)
1 small zucchini, thinly sliced
10 button or baby bella mushrooms, sliced thinly
(Omit if on the SIBO or Candida Protocols)
STEP 1 To a medium mixing bowl, add bison, coconut flour, spices, and salt. Preheat oven to 400° F.
STEP 2 Press bison mixture into the bottom of a large cast iron skillet or glass baking dish. Try to press it down as thinly as possible.
STEP 3 Begin topping the meat-za with the kalamata olive spread (spread onto in one thin layer). Add the thin slices of onion, zucchini, and mushrooms and evenly distribute.
STEP 4 Bake for approximately 25 minutes or until meat is cooked through and vegetables are tender.
Bone Broth Turkey Chili
2 Serving
1 lb ground turkey
4 cups bone broth
1 avocado chopped
2 cup carrots, sliced thinly
1 cup cilantro
1⁄2 cup chopped red onion,
1 tsp ground cumin
Pinch of salt
STEP 1 Heat bone broth in small pan on stove over high heat until it comes to a boil. Add onion, cumin, and cilantro to pot and allow to steep for about two minutes.
STEP 2 Add broth with spices to high-speed blender and pulse until smooth.
STEP 3 Pour half of the blended broth into two bowls each. Top each bowl with half of the ground meat, half of the avocado, and two of the thinly sliced radishes. Season with salt as desired.
Crispy Chicken Nuggets
4 Servings
1 lb boneless skinless chicken thighs 1 tsp dried oregano
1 tsp garlic powder
1 tsp onion powder
1⁄2 tsp salt
1⁄4 cup coconut flour or cassava flour
1⁄4 cup coconut oil or other fat of your choice for frying
STEP 1 Cut chicken into 1-inch pieces. Preheat a large skillet over medium heat.
STEP 2 Add the flour, spices, and salt to a medium bowl and stir to combine.
STEP 3 Add chicken pieces to flour and spice mixture and toss to coat evenly.
STEP 4 Add coconut oil to the preheated pan. Using tongs, place half the chicken nuggets into the pan. Allow these to cook for approximately four minutes on each side until golden brown all cooked through. Add remaining nuggets until they are all cooked.
STEP 5 Serve these with a dollop of mustard and a side salad.
Turkey Lettuce Wraps
2 Servings
Organic turkey sliced thinly
1 avocado
1⁄2 cup shredded carrots
2 tbsp organic apple cider vinegar mustard
1⁄2 cup alfalfa sprouts
4 romaine lettuce leaves
STEP 1 Spread half of the avocado and mustard over each lettuce leaf.
STEP 2 Top avocado-mustard mixture with 4 slices of turkey, for each lettuce leaf.
STEP 3 Place shredded carrots and sprouts on top of lettuce. Fold in half and eat. It will be overflowing so feel free to use a fork to pick up the leftovers.
Turkey Meatballs
5 Servings
1 lb ground dark meat turkey
1⁄2 cup red onion, diced
1 garlic clove, minced
1⁄4 cup parsley, chopped
1⁄4 cup cilantro, chopped
1⁄2 tsp ground cumin
1⁄2 tsp ground coriander
Salt, to taste
STEP 1 Preheat your oven to 425° F.
STEP 2 In a medium bowl, mix the ground turkey with the onion, garlic, parsley, coriander, salt, and cumin. Form the meat into 1-inch balls and place on a parchment paper-lined baking sheet and place in oven.
STEP 3 Cook the meatballs for about 20 minutes or until cooked through.
STEP 4 To serve, place two meatballs with two lettuce leaves, top with sliced cucumber if you like, and serve immediately.
Italian Beef and Broccoli
4 Servings
3 cups broccoli florets (fresh or frozen) 1⁄4 cup olive oil
1 medium sweet onion, thinly sliced 12 oz boneless beef sirloin steak, cut into thin pieces 1 tsp dried oregano 1⁄2 cup basil, minced 1⁄4 tsp salt
1⁄4 tsp black pepper
5 garlic cloves, minced
1 cup bone broth
12 oz kelp noodles or zucchini noodles
1⁄4 cup olive tapenade (optional, for garnish) (Omit if on the SIBO or Candida Protocol)
STEP 1 Preheat a large skillet over medium heat and add 2 tbsp olive oil. Add onion and garlic to pan and cook for about 5 minutes or until tender, stirring occasionally. Set aside.
STEP 2 Place steak strips in the same pan over medium heat. Sprinkle with oregano, salt, and pepper. Cook for about 5 minutes or until steak strips are cooked through. Set aside.
Shepherd’s Pie
Serves 4-6
1 lb carrots
1 lb parsnips
1 cup bone broth
1⁄2 tsp dried ground thyme
1⁄2 tsp dried ground rosemary
1 tsp onion powder
1 tsp garlic powder
1 lb ground beef
2 tbsp lard or bacon grease 1 tsp salt
STEP 1 Wash and peel the parsnips and carrots, and cut into 1⁄2 inch rounds. Place these into a large pot with the bone broth. Cover with a lid, and allow the bone broth to come to a simmer and cook until tender, approximately 10 minutes. If broth evaporates, add more broth or water, so vegetables don’t scorch the bottom of the pan.
STEP 2 While the vegetables are boiling, preheat a large skillet over medium-high heat. Once preheated, add the lard or grease, as well as the meat, spices, and mushrooms. Sautee until the meat is cooked through and the mushrooms are tender. Turn off heat.
STEP 3 Once carrots and parsnips are cooked through, pour any remaining broth and the cooked vegetables into a high-speed blender or a food processor. Season with salt to taste. Blend until smooth. Add more broth if necessary to thin.
STEP 4 Scoop carrot-parsnip mash out of the food processor and dollop onto the meat and mushroom mixture, smoothing it out with a large spoon as you go, to cover the meat.
STEP 5 Place into oven on broil, if you want to get the outer crust crispy. Or serve as is with no additional cooking.
STEP 3 Add remaining olive oil to the same skillet and heat over medium heat. Add broccoli and bone broth and cook until tender but not mushy, approximately 4 minutes.
STEP 4 Once broccoli is cooked, add the beef and onions back to the same pan, with the basil and stir well. Allow to cook for about two minutes to combine flavors.
STEP 5 To assemble, place a portion of kelp or zucchini noodles on a plate, then top with beef and broccoli mixture, then add a dollop of olive tapenade for garnish if desired.
Pasta Salad
Serves 4
1 large zucchini, spiralized
1 lb bacon (organic, no added sugar)
2 avocados, diced
1 cup romaine lettuce, shredded
1⁄2 cup green olives
(omit if on the SIBO or Candida protocols)
1⁄4 cup fresh basil, chopped finely
2 cups cauliflower, raw and “riced” in food processor
3 tbsp olive oil
Salt and pepper to taste
STEP 1 Spiralize zucchini or purchase it already in noodle form.
STEP 2 Preheat in a large skillet over medium-high heat and add bacon to pan. Cook bacon until tender and then allow to cool and crumble by hand.
STEP 3 Shred romaine lettuce and chop basil finely. Place 1 small head of cauliflower in a high-speed blender or food processor and process until it forms a fine “riced” texture.
STEP 4 Add all ingredients to large bowl and toss until well combined.
Introduction
If you’re reading this book, it means you’re looking for answers. I want to assure you that you are on the right path. You still might have a long journey ahead of you, but you’ve taken the first step from a passive to an active approach that will ultimately show you everything you need to know about how to live a long and healthy life not too dependent on medication and symptom-suppressing drugs.
Now, I had been a healthcare practitioner specializing in functional health for more than ten years and after seeing thousands of patients I had never seen anything like it, ever. This particular condition started out as a small rash, tiny red spots on the legs and arms. It was itchy, but he felt it would surely go away without giving it much thought and dismissing it as an allergic reaction.
Now, most of us don’t pay attention to minor changes in our bodies even though we should. We are too busy with our lives to notice until we’re symptomatic and paying the price of living life the way we want. Till the point, we can no longer take the discomfort and the way it is ruining our life. Then what do most people do? They go to the doctor and get some pharmaceutical product to ease or eliminate the discomfort and the symptoms. The problem with this philosophy is that this provides only a short-lived relief, at best. It does not address the underlying cause.
As time passed this particular condition of burning, inflamed skin with chronic itching did not go away, in fact, it got worse, much worse and began spreading all over his body. He was in constant pain and discomfort, with red, inflamed skin that looked like second-degree burns all over his body. The burning, swelling, and itchiness were excruciating. The unbearable symptom started to affect his life significantly. Sleep became all but impossible. The days were filled with debilitating pain at every movement and skin flaking off everywhere. At night, most of the time he was restless and if lucky, was able to get a few hours of sleep. In the morning he would wake up in a pool of blood from a night of scratching his skin till it bled. He was in hell!
He couldn’t bear to look at himself covering his body in loose, long-sleeved clothes, even in the summer to keep people from staring. But as much as he tried his clothes could not hide everything. This still left his hands and face exposed. People could not help but stare, and this caused him great embarrassment. He became more self-conscious and ashamed. He started dreading going out, a trip to the supermarket became an ordeal.
He was a very proud family man with a very loving and supporting wife and newborn baby girl. He loved rocking his little girl in his arms and reading to her. But as his condition deteriorated, he could no longer read to his daughter at bedtime because any movement would be too painful. When he tried to sit and rock with her, the pain would shoot through his body, leaving him wincing in pain. His severe condition along with sleeplessness led to very low energy levels, which affected his focus, attention, and cognition. Soon, he was unable to work, and the spiral into stress and desperation continued to get worse.
It is hard to truly empathize and understand what a patient going through such turmoil thinks and feels. The impact and burden on his lifestyle and his family only added to his stress. His roles as father, husband, employer, not to mention the impact on his self-esteem as a man and provider hit a painful low. Looking back throughout it all, I remember feeling an emotional turmoil of great sadness and frustration.
You see, that guy was me.
Yes, after leading what I considered a full, healthy and vigorous life, this skin condition, or whatever it was, had spread throughout my entire body and had completely taken over my being. Me, Dr. Steve Burlison, functional health practitioner, was struck with a life-halting health condition that no one had answers for. I reached a point where I could not hide this anymore. I remember when I finally told my wife the severity of what was happening and had to admit I was falling apart. This was no surprise to her as she had witnessed this condition progressing and I knew how worried she was. I remember my wife holding me in her arms, looking into my eyes with tears rolling down both of our faces telling me that we were going to figure this out. Here I was - broken, weak, depressed and no longer feeling like a man. At that moment my wife gave me the best gift she could, Hope.
This condition was affecting everybody in my life, my family, my friends, my colleagues and my business. The immediate environment resonates the effects of any disorder and is changed by it. But here’s the thing - it also has the power to influence it positively.
Once I had come clean to terms with my condition and became committed to getting well, I stopped being desperate, and started searching for every conceivable avenue of treatment -- both conventional and alternative -- to find a solution. The best allopathic doctors shrugged their shoulders and told me that all they could offer were steroids to manage the inflammation, but I knew that this condition was not skin deep. I knew that this was not a skin problem at all. In my years of practicing a holistic approach to healing the body, I understood that a symptom could manifest in one part of the body, like the skin, but that the underlying cause may lay elsewhere. My intuition and training told me this was a systemic problem and that I had to dig deeper to find the cause behind it.
Then, the problem became much worse if that were at all possible. I had severe pain shooting through my body to the point that I had difficulty walking. This was especially hard for me as being physically active had been a big part of my life till then. I liked playing sports, loved CrossFit, golf, and hockey. I especially enjoyed being outside and taking walks with my family. All of which I could no longer do. The progression of this condition had hit a point where basic movements cost a massive effort on my part. The pain became constant and unbearable. I lathered myself with coconut oil and Shea butter. While this helped a little and kept my skin from flaking everywhere, it did nothing for the burning, itching, swelling, and redness. I knew external factors did not cause this, and there was something inside my body that was severely dysfunctional.
I consulted with colleagues and some of the best minds in functional medicine across the country. Eventually, we came up with a game plan.
One thing I know for sure is that most physical problems don’t develop overnight. Often, they have been brewing for years, lurking beneath the surface and hidden from view. So, I thought about my previous habits and whether they could have in any way contributed to my current problem.
It was difficult to admit it but my eating habits growing up and into my young adult years hadn’t been the best. In fact, they were downright horrible at times, in part because of the misleading nutritional theories and in part, that as an energetic and continually exercising athlete, I thought I could get away with eating anything I want. But the problem with food is that, for the most part, we see it through the lens of calories eaten and calories burned. As an avid athlete, I would burn off all those extra calories, right? However, food is way more than calories. It can contain toxins that can wreak havoc on our bodies not just at the time of digestion but over decades as we continue to put poisons into our digestive system, three times a day, every day of our lives. Could my eating habits have damaged my gut somehow?
Two critical parts of our amazing bodies are the brain and nervous system along with the gut or let just say the digestive system as a whole. The brain and spinal cord are the control center of the body with an estimated 200 billion neurons between the two and coordinates every aspect of our physical body. The gut is called the ‘second brain’ because it too has neurons that communicate with the brain. In fact, the gut has 500 million neurons and plays a massive part in the transfer of energy from food into the fuel and chemicals that drive the entire body.
The gut environment, or gut biome, is an incredibly delicate balance of trillions of micro-organisms and about a thousand different species of bacteria. What’s more, many of these organisms are unique to each person and have 3000 specific genes. Also factoring into my thinking was my conviction that clearly, I had an auto-immune response and the gut was heavily involved in. In fact, 80% of the immune system is located within or associated with, our digestive function. So, if you have a health issue, hormone imbalances or auto-immune response, the gut is an excellent place to start to look for answers.
I devised a healing protocol to get my life back and improve my gut health. This involved a number of actions, like multiple 7-10 day juice fasts, a lot of bone broth, a list of supplements for nutritional deficits, pre and probiotics, coconut oil and, wait for it -- even daily coffee enemas. This daily protocol took up my whole morning so that I couldn’t even get to anything productive until the afternoon. I also eliminated all sugar. I also realized that I had neglected my intake of healthy fats that are a huge part of the immune response, hormone balancing, and reducing inflammation. One of the reasons was the misleading nutritional information I grew up with that didn’t distinguish good and bad fats and confused us all. I had come to realize that my body was starved for healthy fats.
In addition to the obvious attention to my diet, I also worked on de-stressing emotionally. I prayed, started meditating, as well as tapping (stress reducing technique that we will discuss more in chapter 9), and did everything I could to keep my energy up and my hope alive. And the support that I got from my wife, Toni, was incredible. We tried to go on vacation, and we brought along all the equipment I needed to stay on track, like juicers, supplements and even my coffee enema kit. I was 100% committed. You need to be 100% committed to effect massive change and my painful and frustrating condition made it easy for me to be reminded why I was doing all the things I needed to do. However, without that incentive, I might easily have started cutting corners, lost momentum and would have found myself back at square one. It happens so easily. I have seen it happen to patients I treated in my clinic.
After ninety days on a healing protocol, I took inventory of my progress. I had been journaling so I wouldn’t rely on memory to gauge my progress. As I reviewed my past, it wasn’t clear that I was getting much better, but I certainly wasn’t getting any worse, so I took this as a victory. Besides, I knew this was going to take a long time. It had taken years for me to get to this state and it wasn’t going to change overnight.
I persisted. At my six month milestone, my review showed me that there was indeed some recovery. I was beginning to feel better, and some of the hellish itchiness and redness was fading.
I had no choice but to keep going and over many months, gradually restored myself to full health. It was the most challenging endeavor of my life, but without it, I wouldn’t have had a life.
“Let food be thy medicine, thy medicine shall be thy food.”
– Hippocrates
Over time, I realized what had happened to me. Years of poor diet and living over stressed had eroded my gut lining, making it vulnerable to foreign particles, undigested food, and bacteria, which then entered my bloodstream and were transported all over my body (commonly called a leaky gut syndrome). As a result, my immune system was set in motion to destroy the invaders, leading to the massive inflammation. The protocol I was following helped heal my gut lining and effectively blocking foreign particles from entering my body (more on this topic in chapter 6). I am now living a full life, back to being a healer, doctor and perhaps most important of all, a husband and father.
My journey through this illness highlighted many of the factors that confront almost every patient whom I see in my practice. We focus too much on the present and discount the impact of past behaviors that can have lasting physical and mental effects. We have the wrong expectations about the speed of treatment and recovery. Our impatience, fueled by a culture that treasures convenience above almost everything else, means that we can quickly and even unconsciously sabotage the best of intentions. It’s easy to lose focus in the throes of incredibly busy and demanding lives. The good news is that health can be restored if you’re prepared to take the time and make the effort. And such changes require the constant support of knowledgeable practitioners and the unfading love of family, friends and your doctor.
“Happiness for me is largely a matter of digestion.”
– Lin Yutang
My health journey has made me a better practitioner, a more loving husband, and a more attentive father. I’m able to better relate to my patient’s experiences, seeing them as more than a set of symptoms. This is entirely consistent with the philosophy of functional medicine and genuine health care.
In this book, I will introduce you to functional medicine or called the functional health approach, gut health or the lack thereof (leaky gut syndrome) and the term autoimmune disorder. Unlike conventional allopathic medicine, functional medicine focuses on health rather than symptoms and is designed to promote your health rather than just manage your diseases. Functional medicine is making great strides as more and more practitioners and increasing research data highlight the value of looking at the person as a whole rather than a set of independent parts, like the cardiovascular system, the brain, the digestive system, etc. Even “conventional” research has demonstrated this interconnectedness, not just of the mind and the body, but virtually every part of your physiology. As this notion is becoming more accepted even icons of the allopathic system, like the Cleveland Clinic, are opening up functional medicine departments. In the next chapter, I’ll tell reveal to you why.
“Your body is your subconscious.”
– Dr. Candace Pert
To learn more about this book visit BurlisonClinc.com
Notes Day 14
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Notes Day 17
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Notes Day 18
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Chapter 6
Gut Health And Autoimmune Disease
Gut health and hormonal imbalances are among the primary causes of autoimmune diseases.79 Autoimmune diseases are the body’s equivalent of friendly fire. It occurs when our incredible natural defense system, the immune system, attacks different parts of the body for no apparent reason. The immune system consists of different types of cells; some identify foreign invaders, others kill off these invaders who threaten the proper working of the body.
Currently, there is no clear explanation as to why the immune system starts attacking seemingly healthy organs and tissue. Regardless of the causes, the effects can be devastating. Inflammation is the signature sign that the immune system is in action, and typically this is a signal that it is doing its job and fighting off infections and foreign particles.80 The same process occurs when the immune system attacks healthy tissue, and as a result, extreme and constant inflammation are characteristics of autoimmune conditions. Prolonged inflammation can cause damage, not to mention pain and discomfort.
The immune system can attack almost any part of the body and let’s face it; it wouldn’t be a good line of defense if it couldn’t. The most common targets for autoimmune activity are the brain, skin, mouth, lungs, sinus, thyroid, joints, muscles, adrenals and GI tract. 81
Autoimmune symptoms can exist for years before they become seriously problematic and people seek medical help. Unfortunately, because there’s no easy diagnosis or systemic treatment, the allopathic system doesn’t do very well with diagnosing vague conditions. As a result, the typical response from an allopathic doctor is to treat the symptoms of inflammation with anti-inflammatory medications or, where relevant, topical creams. However, this doesn’t address the underlying issue. In fact, it is estimated that it can take a patient with an autoimmune condition visits to anywhere between 6 and ten physicians to finally get an accurate diagnosis.82 The average time to accurate diagnosis is five years, which makes an autoimmune condition more like a military coup than friendly fire.
Autoimmune conditions are fairly common, affecting about 50 million Americans83. Women are much more likely to be affected than men, although we’re not sure the reason for this gender difference. Common sense suggests that it might have something to do with hormones, but as yet there’s no definitive evidence that is the case.
Here are some of the common signs and symptoms of an autoimmune disorder.
BRAIN: Headaches, brain fog, anxiety, attention problems
SKIN: Rashes, red bumps and flaking skin (sound familiar?) leading to acne, rosacea, dermatitis, psoriasis, and eczema
SINUS, MOUTH, and LUNGS: Asthma, colds, dry mouth
THYROID: Fatigue, hyperactivity, anxiety, weight change, general feelings of weakness
MUSCLES and JOINTS: Swelling, stiffness, pain, weakness
ADRENALS: Fatigue, exhaustion
GI TRACT: Bloating, gas, constipation, cramping, diarrhea
So far, we have identified 80 different autoimmune conditions, each targeting different tissues, and cells. Some of the most common autoimmune conditions include:
Celiac disease, which affects the gut lining
Fibromyalgia, which affects muscles and connective tissue
Rheumatoid Arthritis, which affects joints
Multiple Sclerosis which affects the protective sheath (myelin) around nerve cells leading to muscle weakness, cognitive problems and difficulties with coordination and balance
Systemic Lupus Erythematosus (SLE) affects almost any organ or system in the body including blood vessels, muscles, joints, the digestive tract, lungs, kidneys, heart and central nervous system.
Crohn’s Disease is an inflammatory autoimmune bowel disease characterized by severe and persistent inflammation of the lining or wall of the gastrointestinal tract.
Guillan-Barre Syndrome occurs when the immune system attacks the peripheral nervous system (PNS) which connects the spine and brain to the rest of the body, leading to difficulties with various forms of movement.
Kawasaki’s Disease is a rare condition, typically found in children under the age of 5. Symptoms are high fever, red eyes, lips, mouth, and swollen lymph nodes. The disease seriously affects the heart and the wall of blood vessels.
Meniere’s disease affects the inner ear and disrupts hearing and even movement.
Myasthenia Gravis is a disease that leads to serious weakening of muscles.
Restless Leg Syndrome (RLS) manifests as a powerful urge to move your legs, especially when resting.
Ulcerative Colitis manifests as inflammation and soreness in the rectum and colon.
What Are the Causes?
While we know what happens in autoimmune diseases, i.e., the immune system attacks the body, we’re not sure exactly why. However, there is growing evidence that there is a direct correlation between gut health and hormonal imbalances to autoimmune disorders.
Now, can some people be more genetically susceptible to autoimmune conditions than others, or autoimmune sensitivities? Yes. When you combine a possible genetic link along with poor gut health, we now have a recipe for disaster. Whether the condition is manifested as a result of your genes in combination with exposure to certain physical and environmental factors, is a matter up for discussion but entirely possible. This interaction between genes and environment is called epigenetics.
The environmental factors that have been associated with autoimmune conditions include:
Exposure to toxins, pesticides and heavy metals
Exposure to hormones and additives in food and packaging
Heavy use of antibiotics and sanitizers
Chronic stress
Poor sleep
Lack of exercise
Nutrient deficiency -- poor diet
It’s not surprising to see the usual suspects in the above list -- the lifestyle behaviors associated with health and wellness. We know that stress significantly impacts the functions of the immune system, hence the association of stress with all sorts of diseases and conditions. Exercise boosts all major functions, including the immune system, as does sleep. Of course, what we eat is also a huge part of our health. That’s not just the food but the action of the gut, too as well as our bathroom habits.
If you were paying attention while reading the introduction, you’d recall that my skin problem was a classic autoimmune disorder and was eventually traced to problems in my gut. Indeed, the gut is typically the place to start when investigating possible autoimmune conditions. Let’s go over why the gut is so critical to immune system problems:
80% of the immune system is located in the gut
the gut and immune system share communication, influencing each other
the gut is the main entry point into the body for foreign and toxic particles
the gut influences many immune system processes
As mentioned above, many well-known diseases are autoimmune conditions. However, autoimmune problems don’t necessarily have to result in diseases. Autoimmune reactions can lead to sensitivities or manifest as less than a disease. As a result, allergies, food intolerances or digestive issues can achieve less than disease status but still cause problems that can go undiagnosed for many years but still cause discomfort. Many times, people dismiss these sensitivities as part of who they are without recognizing they can now be accurately assessed and treated; they don’t have to be lifelong issues that you bravely and stoically bear.
The Case of Sue
Susan is a 58-year-old grandmother and wife, with a long history of inflammation in various parts of her body. Her brother, whom she trusts implicitly, is an allopathic physician and has recommended numerous anti-inflammatory medications over the years, and while they sometimes gave temporary relief, they never resolved the underlying problem. He thought that she was genetically predisposed to the condition and so she bravely put up with it, taking medications only when it became painful or debilitating.
During a recent difficult period in her life, she came to me for the management of some digestive issues that she attributed to some very stressful circumstances. Her inflammation had also flared up, but she had gotten so used to that she didn’t even report it as a symptom until she was asked directly about all aspects of her physical state.
Testing revealed issues with her gut lining that I suspected were causing both her digestion problems and her inflammatory condition. After treatment to heal her gut lining was complete, she started to feel better and began to buy into the idea that her inflammation might be an autoimmune condition that could be treated. For the first time, she had hope that she might be able to rid her body of inflammation altogether.
The immune system can go awry for several reasons.
It can be exposed to severe levels of toxicity, resulting in a major immune and inflammatory response. Those toxins could come in many forms; chemicals, foods, bacteria, etc.
The immune system can overreact to a foreign substance, leading to a larger than necessary response.
The immune system can then start attacking healthy tissue.
Autoimmune responses can, therefore, occur because of external and internal environmental conditions or a combination of both. It can get overwhelmed and malfunction when a lot of internal and external stressors occur at the same time. So, there may be some foods or toxins that your immune system can normally cope with effectively, but when it is overwhelmed it has no resources left to deal with those toxins, and you have an autoimmune reaction to them. This is what happened to Sue in the case described above. Faced with added stress, her immune system could no longer deal with her digestive issues. The level of stress contributes to what is called the “allostatic load” -- the wear and tear on the body.
What follows from this is that we have responsibility for our behaviors and actions that might increase allostatic load and create autoimmune sensitivities if not outright diseases.84 Many of our decisions influence the body, and they certainly influence our emotions and stress levels, from the decisions we make to the way we deal with difficult situations.
Specific tests can now be performed that can help us locate and diagnose an autoimmune problem. In fact, autoimmunity is a good example of the value of functional medicine; we can now use sophisticated tests to drill down to cellular level and assess what is happening rather than just treat at a symptomatic level.
As you have already learned, the gut is a great place to start when considering possible autoimmune issues. Much of the immune system resides in the gut or is associated to and influenced by it, so it’s a natural place to start. There are now several valuable tests that can assess gut problems, and when there are gut problems, an autoimmune condition is probably lurking somewhere. A stool test is important because it gives a good indication of what is going in that complex gut microbiome, where millions of good and bad bacteria live. It can indicate the state of that important balance in your intestines and how much of the good and bad bacteria are being eliminated. An analysis of eating habits is also important as well, as it might identify foods that the patient is sensitive to or is creating a problem in some other way.
Other tests that can help clarify autoimmune involvement include checking blood levels for antibodies and any underlying infections along with hormone levels. Also, I will screen for hidden toxins like lead or mercury or any fungal growth. Remember, the immune system is activated by foreign objects in your body. These objects are called “antigens” which means “not self.” They are foreign invaders, and your immune system is dedicated to getting rid of them.
While problems in your gut can create autoimmune difficulties, the foods we eat can create problems with your gut and your immune system. It’s a closed system.
The food supply today is tainted with many toxins and unnatural products that are potentially harmful to our bodies. Processed food is, as it sounds, food that has been processed in the factory, not in your body. As a result, many of the toxic ingredients get absorbed into the system, and these can create serious issues. It’s not just the addition of massive amounts of sugar and salt, which significantly contribute to massive health problems, it’s other substances, too. Here’s a list of some of the most common toxins routinely put in many foods:
Sodium Benzoate and Potassium Benzoate are preservatives that are added, for example, to sodas to prevent the growth of mold. However, benzene has been associated with damage to the thyroid, a key structure involved in metabolism.85
Butylated Hydroxyanisole (BHA) is a preservative that has been cleared as “safe” by the FDA. It’s in many, many foods but it disrupts the endocrine system, thus influencing your hormones and thus your entire system.86
Sodium Nitrates and Sodium Nitrites are preservatives found in processed meats which have been associated with colon cancer and diabetes.87
Blue, Green, Red, and Yellow artificial coloring, some of which are banned in other countries, have variants that have been linked to numerous cancers, including brain cancer.88
MSG is added to foods as a flavor enhancer, and while some glutamates seem harmless, there is research which suggests that MSG can alter brain chemistry.89
Then, of course, there is the way animals are raised. Many are given extra hormones and other additives to make them grow,90 and these can be passed on when you eat the food products that come from them.
I could go on and on, but the point is that processed foods contain many harmful substances that can require immune system action, thus taxing your system and putting extra load on it. Also, some of these toxins impact the immune system itself.
Activity and exercise are natural for humans, vital for their survival and essential to health.91 However, as a species, we have become increasingly less active and adopted a sedentary lifestyle.
Some research has shown that the amount of required activity in the workplace has declined to the point where employees now use more than 100 calories less a day in workplace activity than they did 50 years ago.92 That may not sound like much, but assuming the typical employee works about 250 days a year, that’s a 25-30,000 calories deficit, or about 8 pounds of weight gain a year -- every year. So, after five years that would be the equivalent of 40 pounds. And that is just reduced activity in the workplace and doesn’t address the reduction of activity in non-work times.
Moreover, exercise and activity are not just about calories. Exercise is critical to brain function and preservation, producing important chemicals like Brain Derived Neurotropic Factor (BDNF) which is a protein associated with cell growth and health in the brain and elsewhere in the body.
Exercise is critical for healthy heart function, 93which has the important task of getting blood to every part of the body. As we will discuss later, exercise isn’t just about going to the gym; it’s about your level of activity throughout the day. We now know that being sedentary is a serious health risk and that physical activity is essential.
Another essential lifestyle behavior is sleep. Millions of people have poor sleeping patterns; either not getting enough sleep or getting poor quality sleep. Sleep helps restore energy and critical functions, and without it, especially on a prolonged basis, you will suffer. In particular, sleep or lack thereof influence’s the metabolic and endocrine systems94 as well as impacting behavior95. In one study, 5% of people admitted to having fallen asleep at the wheel in the past month!96
So, lifestyle choices have a huge impact on the load placed on the immune system and contribute to the availability of other resources like energy that can overwhelm natural functions and lead to autoimmune problems.
In addition to our habits, other toxins can be introduced into the body, either deliberately or unknowingly.
One particularly contentious issue is the subject of vaccinations. Typically, vaccinations consist of getting a small amount of the disease that you’re trying to protect yourself from, so that your immune system can learn to identify it and deal with it effectively without being overwhelmed. The theory behind vaccinations is that they give your immune system practice at identifying and managing a particular disease. Overall, if vaccinations are safe and do what they advertised to do this makes perfect public health sense. However, given what we know about individual variation in genetics, biology, and lifestyle, to name but three, it seems unlikely that everybody gets benefits from vaccinations and highly plausible that they harm people.97 Doctors simply follow a routine schedule for administering vaccinations and don’t as much as take into account if a baby was born premature – does it make sense to give the same quantity of drugs to a human being who is younger at the time of administration of the vaccine simply because they were born sooner as, say, a healthy, full-term baby? In this book I don’t want to get into a debate on whether to have a vaccination or not have a vaccination but let me share some of my concerns.
1. The pharmaceutical industry holds no liability for any adverse effect or damage caused by vaccination even when proven in a court of law. Every year, more than 25,000 adverse reactions are reported to the government, including irreversible injuries and deaths. It’s been estimated that this represents only about 1 to 10 percent of total vaccine reactions, which means that millions of people may have suffered vaccine reactions and injuries over the past few years.98
2. There are no long term safety tests.99 Vaccines have not been adequately tested for safety using methodologically sound scientific studies, so their long-term health effects are unknown. Moreover, the effects of multiple vaccines given together have not been properly tested.
3. Current vaccination schedule is 49 doses of 14 vaccines before the age of 6 and 26 in the first year of life alone. This is compared to 10 by age 6 in 1983. My thought is why this massive increase or need for 28 extra vaccinations when serious diseases like measles, influenza, mumps and whooping cough were long in decline before mass immunization was introduced?100
4. In 2015, the Pharmaceutical industry spent 238 million dollars lobbying for new laws and products.101 And pharmaceutical companies have financed nearly all vaccine research to date, which introduces enormous bias.
5. A controlled study published in BMJ in school-age children diagnosed with whooping cough, over 86% of the children were fully vaccinated and up to date for the whooping cough vaccine?102
6. Mortality for the common illnesses had declined significantly long before the vaccines were created.103 There are multiple reasons for this, but some of them include the overall improvement in the quality of life for people with access to clean water, plumbing, food and animal control and health education all being contributing factors.
Vaccinations are a hot topic and an important issue. Each person and parent has to decide for themselves the value of getting them. Unfortunately, however, there is a lot of hysteria and misinformation on this issue as well as intentionally discredited research that sheds some light on a very painful topic. The bottom line is that people need to be informed about their health choices and how the body’s current state, possible untreated conditions, environmental factors and/or genetic predisposition can lead to adverse reactions against widely-prescribed and administered drugs and treatments. For example, children with GAPS (Gut and Psychology Syndrome) have been recorded to have an exceptionally high risk for vaccine adverse reactions, so a test for GAPS prior to vaccination may be a good idea for some parents.
The hope and likelihood are that further research will reveal what personal factors are associated with potential adverse effects from particular vaccines. In the meantime, however, we should recognize that some people are adversely affected by vaccines, while others are not. As vaccines are meant to alter the immune system, we cannot ignore the possibility of these alterations causing possible damage to the immune system leading to either an autoimmune disease or autoimmune sensitivity.
In addition to consciously giving ourselves substances that specifically challenge the immune system, many environmental toxins exist. They are cancer-causing chemicals104 and metabolic disruptors, both human-made and naturally occurring that can cause illness and specific sensitivities.
One of the most common toxins is lead, which can be found in many products, from paint, gasoline and even in the water supply. Exposure to high levels of lead in pregnant women or young children can lead to serious cognitive and intellectual problems.105 Poor air quality has been linked to heart and lung disease. These toxins seriously tax the immune system, reducing its overall efficiency and raising the risk of autoimmune problems. Pesticides can show up in the food you eat as well as affect the environment, creating more potential dangers.
So as you can see, there are many ways your immune system can be challenged to the point where it becomes inefficient or even dysfunctional. Our best hope is continued research and the development of tests that show how the body is responding at a deeper, cellular level before problems become chronic.
The good news is that the availability of sophisticated tests can help define when the body is beginning to break down, rather than waiting for it to become obvious through symptoms. When I explain these tests and what they can do, most people are pleasantly surprised by what is possible, and I see that perhaps for the first time in a long while, they can see hope. And as we already know hope is a very important part of recovery.
79 The effect of anti-thyroid antibodies positivity on children with primary immune thrombocytopenia; Mousa SO, Soliman GT, Saedii AA, Hameed EN
80 The Inflammatory Response
81 Immune system: an emerging player in mediating effects of endocrine disruptors on metabolic health; Bansal A, Mejia JH, Simmons RA
82 How Autoimmune Diseases Are Diagnosed and Treated (https://www.verywell.com/how-are-autoimmune-diseases-diagnosed-and-treated-3232651)
83 Autoimmune Disease Statistics
84 In immune defense: redefining the role of the immune system in chronic disease; Rubinow KB, Rubinow DR
85 Combined repeated-dose and reproductive/developmental toxicity screening test of benzene, 1,1’-oxybis-, tetrapropylene derivs. in rats; Tsubokura Y, Hasegawa R, Aso S, Kobayashi T, Koga T, Hoshuyama S, Oshima Y, Miyata K, Kusune Y, Muroi T, Hashizume N, Inoue Y, Ajimi S, Furukawa K
86 Endocrine Activity of AVB, 2MR, BHA, and Their Mixtures; Klopcic I, Dolenc MS
87 Sodium nitrate ingestion increases skeletal muscle nitrate content in humans; Nyakayiru J, Kouw IWK, Cermak NM, Senden JM, van Loon LJC, Verdijk LB
88 Food additives: Sodium benzoate, potassium sorbate, azorubine, and tartrazine modify the expression of NFκB, GADD45α, and MAPK8 genes; Raposa B, Pónusz R, Gerencsér G, Budán F, Gyöngyi Z, Tibold A, Hegyi D, Kiss I, Koller Á, Varjas T
89 Monosodium glutamate and treadmill exercise: Anxiety-like behavior and spreading depression features in young adult rats; Vitor-de-Lima SM, Medeiros LB, Benevides RDL, Dos Santos CN, Lima da Silva NO, Guedes RCA
90 Steroid Hormone Implants Used for Growth in Food-Producing Animals
91 Exercise Alters Gut Microbiota Composition and Function in Lean and Obese Humans; Allen JM, Mailing LJ, Niemiro GM, Moore R, Cook MD, White BA, Holscher HD, Woods JA
92 Good food can improve workers’ health – and their motivation
93 Cardiorespiratory Fitness and Health Outcomes: A Call to Standardize Fitness Categories; Kokkinos P, Myers J, Franklin B, Narayan P, Lavie CJ, Faselis C
94 Insomnia and Risk of Cardiovascular Disease; Javaheri S, Redline S
95 [Effects of a Sleep Improvement Program Combined with Aroma-Necklace on Sleep, Depression, Anxiety and Blood Pressure in Elderly Women]; Chun N, Kim M, Noh GO
96 Asleep at the Wheel: The Prevalence and Impact of Drowsy Driving; (https://www.aaafoundation.org/sites/default/files/2010DrowsyDrivingFS.pdf)
97 Excessive Vaccine Doses Cause High Infant Mortality Rates, Dr. Mercola
98 Vaccines and “Vaccine-Preventable” Disease Research
99 Vaccinations: The Expanding Role of Pharmacists
100 Disease decline before introduction of immunisation
101 Annual Lobbying on Pharm/Health Products
102 Whooping cough in school age children presenting with persistent cough in UK primary care after introduction of the preschool pertussis booster vaccination: prospective cohort study; BMJ 2014; 348 doi: https://doi.org/10.1136/bmj.g3668 (Published 24 June 2014)
103 Disease decline before introduction of immunisation
104 Thyroid Disrupting Chemicals; Calsolaro V, Pasqualetti G, Niccolai F, Caraccio N, Monzani F
105 Interaction between DRD2 and lead exposure on the cortical thickness of the frontal lobe in youth with attention-deficit/hyperactivity disorder; Kim JI, Kim JW, Lee JM, Yun HJ, Sohn CH, Shin MS, Kim B, Chae J, Roh J, Kim BN
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Notes Day 21
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Notes Day 10
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Time For Desserts
Chocolate-Berry Pudding
Serves 2
1 cup strawberries, frozen
(You can also use fresh, but frozen have more concentrated flavor)
2 dates, pitted
1 can full-fat coconut milk
4 tbsp unflavored grass fed gelatin
2 scoops Protein Powder, Chocolate
Pinch of salt
1⁄2 tsp vanilla extract
STEP 1 Preheat a small pan on the stovetop over medium heat. Before pan is warm, add coconut milk and gelatin and whisk well to combine until gelatin thickens. Remove pan from heat and add dates and allow to steep for about 3 minutes to soften dates.
STEP 2 Pour all the ingredients into a blender and blend until smooth. Transfer mixture into two small ramekins and chill in the fridge for about 4 hours, until set. Serve cold.
Gelatin is the star in this pudding since it’s used to thicken and provide a smooth texture, but it’s also excellent for healing the loose cell wall junctures in a leaky gut. The addition of the Paleo Protein Powder makes this pudding full of healthy protein to keep you energized, and the coconut milk adds fat and antimicrobial properties.
Berry Chocolate Bars
1 (4 oz.) cups almond flour
1 teaspoon coconut flour
¼ teaspoon baking soda
¼ teaspoon salt
2 tablespoons coconut sugar
¼ cup coconut oil, melted
2 tablespoons maple syrup
For the chocolate layer
½ cup canned full-fat coconut milk
5 oz. bittersweet chocolate, finely chopped
About 1 cup of assorted fresh berries
Step 1 Preheat oven to 350°F. Line an 8x8-inch pan with parchment paper or foil and grease lightly.
Step 2 In a large bowl, combine the almond flour, coconut flour, baking soda, salt, and coconut sugar. Whisk to combine. Add the coconut oil and maple syrup and toss to combine until the mixture sticks together.
Step 3 Press the crumb mixture evenly into the bottom of greased pan. Bake at 350°F for 11-13 minutes, or until golden brown around the edges. Let cool completely.
Step 4 Place finely chopped chocolate in a large bowl. In a small saucepan, bring coconut milk to a boil. Pour hot coconut milk over chocolate and let stand 1 minute, then stir until smooth and creamy.
Step 5 Pour warm chocolate mixture over cooled crust. Arrange the berries on top as desired. Chill for at least one hour. Cut into 16 squares with a sharp knife.
Daily Drinks
Gut-Healing Ginger & Apple Cider Vinegar Tea
1 teaspoon fresh ginger root
2 teaspoon Apple Cider Vinegar
2 cups purified water
Sweeten to flavor with Stevia
Step 1 Grate the fresh ginger root into your teapot.
Step 2 Pour 2 cups of water into the pot and boil.
Step 3 Strain.
Step 4 Stir in Apple Cider Vinegar.
Body Healing Bone Broth
2 lbs of beef bones
4 organic chicken legs
6 whole cloves garlic
1 chopped onion
2 tbs coconut oil
2 tbs organic apple cider vinegar
Himalayan sea salt to taste
Step 1 Fill your pot three-quarters full with water and add the herbs and vegetables.
Step 2 Cook on medium-high until bubbling, then reduce heat to low and allow to simmer covered, at least 8 hours, up to 24 hours.
Step 3 Allow to cool, then pour stock through a strainer and transfer to Mason jars to store in the fridge.
For more awesome recipe ideas visit us at BurlisonClinic.com
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Notes Day 16
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Chapter 5
Hormone Balance And Gut Health
Okay, let’s get scientific here. What came first - the chicken or the egg? The reason I ask this question is that there’s a growing amount of evidence that leaky gut is a major contributing factor to hormonal imbalance60. There is also evidence that hormonal imbalance is linked to leaky gut61. So, I have found it a good rule of thumb to test for both gut health issues along with hormonal imbalance as many times they go hand in hand. Hormones play a huge part in the digestive system. Hormones also help regulate the body and are produced by your endocrine system which is made up of glands that produce and secrete hormones and chemicals that regulate the body’s growth, metabolism, sexual development and cognition. The need for balance in these chemicals is reflected by the fact that some hormones turn on a system (such as your digestive system) or turn it off (suppress it). For example, the hormone leptin controls energy and the burning of fats and turns appetite off, while another hormone ghrelin, does the opposite. Because many hormones have a significant impact on digestive functions as well as sleep, sex, stress, and mood, imbalances can result in significant dysfunctions throughout your body, and that eventually lead to the disease process.62
When hearing about hormones sometime, people think of only the sex hormones, and indeed estrogen, progesterone, and testosterone are essential and have a major impact not just on sex drive but other functions, too. However, there is so much more to hormones and how differences in hormonal imbalances can affect men and women. Let’s go over the six primary hormonal imbalance body types that might be stemming from a leaky gut or poor gut health (dysbiosis) or contributing to poor digestive health.
#1. Ovary Body Type
The ovaries have the remarkable job of playing a major part in giving life to another human being. They are often misunderstood because of the complexity of the interaction between the pituitary and adrenal glands. Testing is also very complicated; should you use saliva testing? Or blood testing? Or dried urine testing? Should you test on certain days or during the entire cycle? There are also very different approaches to balancing these hormones. You have bio-identical hormones, nutritional glandulars, eastern herbs, western herbs, hormone replacement, acupuncture, chiropractic techniques, and many drugs to choose from.
It is no wonder that a woman can be quite confused and end up feeling like an evil science experiment! Let’s process this one little step at a time starting with some of the basics. Let’s start with the cycling hormones before we get to perimenopause and menopause. The ovaries produce different hormones to signal different important events during the 28-day cycle. These hormones affect the pituitary, the adrenal glands, and the uterus. As the cycle starts, estrogen comes in heavy to build-up tissue (lining). They call this “Estrogen Dominance” because estrogen is dominant over progesterone in only the first half of the cycle (days 1-14). Then the ovaries and pituitary communicate with two hormones; LH and FSH. These hormones signal the release of an egg. Once the egg is released, estrogen winds-down and progesterone becomes dominant to maintain pregnancy in days 16-28. If no pregnancy, occurs then the uterine lining sheds (the period) and the cycle starts all over again.
During the beautiful change of life from cycling to not cycling, there are changes in function. The production of estrogen declines from the ovaries and progesterone that came from the egg dropping process is now manufactured by the adrenal glands.
The Ovary Symptom Pattern
The symptoms we see are two-fold. In one corner you have fertility symptoms, and in another corner, we see menopausal symptoms. In cycling women, the major problems that are experienced are related to estrogen dominance through the ENTIRE cycle instead of in just the first half. This is typically caused by a failed liver detox process (excess estrogen cannot clear), environmental exposure (including synthetic hormones), and poor pituitary signaling. This is where PMS comes from. The symptoms include cramping, clotting, emotional extremes, irregular cycles, etc.
In the other corner, we get menopausal symptoms, commonly referred to as “Adrenapause.” They call it this because the adrenal glands are so tired and blood sugar imbalances so rampant that progesterone deficiencies cause an imbalance and symptoms.63 You see, progesterone turns into cortisol in the cholesterol hormone pathway. Cortisol is used to balance blood sugar. Most of the time the body treats blood sugar (energy) imbalances before it tries to balance hormones. Therefore, these women are stuck in Menopause Hell dealing with hot flashes, weight gain, headaches, digestive issues, exhaustion, and sleep problems. Not fair… but fixable.
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Ovary Body Type
The ovary body type has two very distinct features. Weight gain along the hips and a reduced bust size. What is the role of Estrogen in all of this? It builds tissue, plain and simple. If you have too much, then you will build tissue around where you make it. That area just happens to be around the ovaries, hips, and lower-stomach. There is also a growing consensus that estrogen dominance along with elevated blood glucose plays a large role in the development of fibroids and cysts64 which can get to the size of a softball!
Why would the breast tissue shrink in this body type? Mostly because of these same fibroids and cysts. Cysts grow because of excess estrogen, but the growth itself produces testosterone. In fact, if we look back to the cholesterol hormone pathway, estrogen turns into testosterone too, for a double whammy! This excess testosterone will lead to facial hair, a deeper voice, and reduced bust size.
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Being a woman is superhuman, but with typical American lifestyle habits65, the symptoms and body composition changes are, well, not fair. If you match some of these symptoms and body composition patterns, then you should take the questionnaire and see where to start testing to find your priority. Testing is key to understanding how tired your ovaries are and what steps may be necessary to recover their function.
#2. Gonadal Symptom Patterns and Body Type
Elevated blood sugar over time will decrease your sexual abilities, muscle mass, and stamina.66 There is an inverse relationship between testosterone and insulin, meaning that if insulin goes up, then testosterone will go down. Insulin is a hormone that puts sugar into muscle tissue to help make energy. Testosterone is a sex hormone produced by the testes.
Gonadal Types start as many of the types of blood sugar problems (which in turn spikes insulin). Over time a condition called insulin resistance forms. This is when the hormone receptor sites get tired and cannot accept any more insulin.67 Excess and free sugar can roam the body causing many issues that include pain and joint problems.
The Gonadal Hormone Symptom Pattern
The Gonadal Hormone Type is caused by a combination of high insulin resistance, high estrogen, and low testosterone. This type has issues with sexual ability (decreased morning erections, sex drive, erectile dysfunction). This type also has problems with bone mass, fat distribution, muscle mass, strength, and the production of red blood cells and low sperm counts. Many experience male pattern baldness from too fast a conversion of testosterone to DHA.68
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Gonadal Hormone Body Type
It should be no surprise that this hormone type has symptom patterns that are defined by female characteristics. Excess estrogen that cannot be cleared from the liver can change the body in many ways. This male type is prone to “man boobs,” erectile dysfunction, low sex drive, male pattern baldness, prostate problems, and weight retention around the hip area (“front butt”), and even a higher voice.69
Keep in mind that men are regularly overdosed by pharmaceutical bio-identical testosterone replacements and can see a conversion into estrogen, leading to the same symptoms that they are trying to avoid. A trained Functional Medicine Practitioner can offer ways to clear the excess estrogen, reduce insulin resistance, and stimulate testosterone production.
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Summary
If you match some of these symptoms and body composition patterns, then you should take the questionnaire and see what testing may be right for you. Testing is key to understanding how tired your gonads are and what steps may be necessary to recover their function.
#3. Liver Symptom Patterns and Body Type
Did you know that the liver helps balance your hormones? Your liver is a remarkable organ that is located on your right side just under your rib cage and is in charge of removing excess hormones and toxins from of your body, converting inactive thyroid hormones to active ones, breaking down fat globules into smaller particles, and balancing blood sugar. The list of symptoms attributed to the liver is extremely long because of how many enzymatic functions it completes (over 500).
The Liver Symptom Pattern
Like all of our endocrine glands, we have patterns of symptoms that are directly tied to how well the gland is functioning and communicating with other above or below glands in the HPA axis. The most common adrenal symptoms are related to low or high cortisol, DHEA, and progesterone. 70Cortisol made by the adrenal gland balances blood sugar, so tired adrenal glands lead to unregulated blood sugar. Many adrenal fatigued individuals have energy problems and sleep problems. So they are exhausted in the morning. Thus the caffeine junky epidemic, sleepiness and mood swings after a meal (unregulated blood sugar), and insomnia. Food cravings are also common, especially for salt. Sodium is used to create the mineralocorticoid hormones that the adrenal glands make.
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Liver Body Type
Everyone has seen a “beer belly.” It sticks out and looks like a person is hiding a water balloon under their shirt. This isn’t that far from the truth as this condition is called ascites. Ascites means “baglike dropsy,” from askos “bag, sac.” The accumulation of serous fluid in the abdominal (peritoneal) cavity.
You do not have to be an alcoholic to have a “beer belly”! In fact, physicians living in Dubai report that a large percentage of the male population have this body type yet the city is dry (no booze). So if they are not drinking a lot of alcohol, why are their livers so stressed? Blood sugar! That is right; they are sugar-holics… ice cream, soda, rice, noodles. These are all absolutely chock full of sugar. That sugar takes a toll on the body, including the liver whose job is to store sugar, and keeps circulating blood sugar levels constant.
Over time, as the liver becomes tired from trying to balance blood sugar levels while removing excess hormones and toxins, body changes start to happen. Little brown spots called AGES (age spots) appear on the hands and feet. AGES stands for Advanced Glycation End Products from failed blood sugar metabolism. If toxins cannot detox through the liver, you see them trying to detox through the skin. Therefore, it is common to see itchy rashes, eczema, or psoriasis in these types. If excess estrogen is not clearing through the liver, you might see little red spots called Cherry Hemangiomas which are typically seen on the chest or belly.
The liver also makes bile to break down fats into smaller particles. If the liver is burdened and tired, you will see symptoms related to poor fat metabolism including vitamin A and D deficiencies.71 This is seen as really thin arms and legs with very little fat. Fat also adds moisture to the skin, so you also see dry and red blotches on the hands and face.
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Summary
The liver is an amazing organ that can regenerate very quickly. Because of the relationship between the pancreas, adrenal glands, thyroid gland, and liver, it is not uncommon to be a mix between multiple body types. If you match some of these symptoms and body composition patterns, then you should take the questionnaire and see where to start testing to find your priority. Testing is key to understanding how tired your liver and gallbladder are and what steps may be necessary to recover their function.
#4. Thyroid Symptom Patterns and Body Type
The thyroid gland controls your metabolism. If you are feeling tired, lethargic, slow, and cannot even get out of bed, you are not alone. According to the American Thyroid Association, “More than 12 percent of the U.S. population will develop a thyroid condition during their lifetime. An estimated 20 million Americans have some form of thyroid disease. Up to 60 percent of those with thyroid disease are unaware of their condition.”72
Many make the fix to thyroid problems seem simple. We see the “solution” in two camps. In the first camp, they say, “You Need Thyroid Hormones (T3 or T4)!”. In the other camp, they say, “You Need More Iodine!” There is a fundamental flaw that both camps may be missing — these approaches can cause muscle breakdown. There is a growing and radically safer approach that hinges on the belief that the body has an intelligent design. We think that the body is slowing itself down on purpose.
Why would the body slow itself down you may ask? To keep from eating away at its own muscle tissue. The hallmark of the thyroid type is low muscle mass, poor protein digestion, and pitting of the skin (cellulite). If you speed up the ability to metabolize protein with synthetic hormones or iodine without fixing the underlying protein digestion, you could be in for some serious side effects!
The Thyroid Symptom Pattern
Thyroid symptoms are either from too fast metabolism or too slow metabolism. Because we have the stuff to get done, like yesterday, then we do not have time to listen to our bodies and provide rest. Instead, we whip the tired horse (that’s our thyroid gland) with stimulants. Sugar, simple carbohydrates (bread and pasta), caffeine (soda, tea, coffee), and drugs become our preferred delivery methods. Therefore, a tired thyroid becomes a vampire, looking for its next fix.
As metabolism slows down, then everything slows down… thinking, digestion, energy, speech, reflexes, emotions, willingness to work, hair growth, etc. You name the function; then the thyroid will slow it down. Many things can cause the thyroid to slow-down, but a few main reasons should be ruled out with lab testing.
The first and most obvious is undigested proteins. Proteins are the building block of the body. Without it, we starve, and when we starve, we slow down. The next reason our thyroid glands slow down is usually because of where we live. For example, Burlison Clinic is in the “Goiter Belt,” named after the expanding thyroid looking for iodine. We get iodine from the ocean. If you live in the middle of the United States far from iodine and not supplementing it, then you will start to slow down. T4 and T3 are named after the molecules of iodine. T3, the active hormone has three molecules of iodine and T4, you guessed it has four molecules of iodine. Finally, the conversion of inactive thyroid hormone (T4) to its active form (T3) mostly happens in the liver. If the liver is overburdened, then this conversion can be poor.
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Thyroid Body Type
The thyroid body type is two-fold. Hyperthyroid or Hypothyroid and yes, you can be both at the same time. Many doctors think that all thyroid issues start hyper (even as children) before the thyroid gets so tired that it becomes hypo. With a slow metabolism and poor protein digestion you start to see the outer third of the eyebrows thin out, in fact, all hair becomes coarse, dry, and thin. You also see uneven weight gain. This is when the body puts on weight all over, including the fingers.
As the thyroid goes searching for more iodine, it expands and can have serious long-term consequences73. You can notice this growth on the neck with a signature double-line. Many find dry patches near the eyes with dry and cracking nails. Studies show that this could be because of the poor protein metabolism from a stressed stomach and pancreas, and incomplete fat digestion from a stressed-out liver. Finally, with poor protein metabolism, the body will start to steal protein from tissue, including the skin. This can be seen as cellulite or “pitting.”
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Summary
Do these body changes and a slowed metabolism sound familiar? If you match some of these symptoms and body composition patterns, then you should take the questionnaire and see where to start testing to find your priority. Testing is key to understanding how tired your thyroid glands are and what steps may be necessary to recover their function.
#5. Pituitary Symptom Patterns and Body Type
The pituitary gland regulates hormones. It has been described as the “Master Gland” of the endocrine system. It is attached to the Hypothalamus which is considered part of the limbic system. The limbic brain evolved in the first mammals. It records memories of behaviors that produced good and bad experiences. It is responsible for what are called emotions in human beings.
So if someone says that your emotions are all in your head, then they are correct! But what they are also failing to tell you is that they are in your thyroid, liver, adrenal, and gonads since they create hormones that communicate back to your pituitary and thus your limbic brain…
The pituitary gland is very sensitive to outside stimuli as it is developing.74 We know this because the smallest and tallest humans all have some pituitary connection. You see, the pituitary is in charge of making Growth Hormone (GH) that grows things, like bones and tissues.
It is very important that the signals (hormones) from the pituitary get to the desired location or you can experience fertility problems, leaky gut, bone fractures, etc.
The Pituitary Symptom Pattern
Once the adult has fully developed, then the under-developed or malnourished gland can become tired, and symptoms can develop. There are a few foods, herbs, and activities that stimulate the pituitary. Long distance running, breastfeeding, sex, drinking milk, ginseng, magnesium, manganese to name a few. Why would a craving for milk be witnessed in Pituitary Types? Milk contains naturally occurring pituitary hormone stimulation (exogenous gonadotropin-releasing hormone (GnRH)).
Pituitary growths including tumors75 can exhibit symptoms such as blurred vision, yellow or green discharge from the mammary glands (breasts), a whole range of seemingly unrelated areas of the endocrine system.
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Pituitary Body Type
Pituitary symptoms are first witnessed as children develop. Too fast or slow, then the pituitary can be supported. Early Endocrinologists such as Henry Harrower MD, prescribed pituitary glandular extracts to under-developing children. Modern practitioners still prescribe synthetic pituitary hormones if a child is falling behind in their growth development chart.76
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Summary
It is very important to understand if the pituitary gland needs treatment or nutritional support. If you match some of these symptoms and body composition patterns, then you should take the questionnaire and see where to start testing to find your priority. Testing is key to understanding how tired your pituitary glands are and what steps may be necessary to recover their function.
#6. Adrenal Symptom Patterns and Body Type
When most people stop and think about what contributes to stress in their lives, “adrenal glands” likely doesn’t make the list. We likely imagine how much more manageable everything would seem if we could just get more sleep, feel more energized in our daily lives, or lose a little bit of weight.
But what if the secret to managing our stress lay in understanding the adrenal glands?
Adrenal glands, which work together with the endocrine system to process and respond to external stimuli, are in charge of regulating stress and blood sugar. Many people’s adrenal glands are overworked and overstimulated. This is due to our tendency to cope with stress by consuming high quantities of caffeine, energy drinks, and high-fat, high-sugar foods. This coping method leads to the common Adrenal body type and many uncomfortable symptoms such as weight gain and an unshakeable feelings of lethargy. It’s an unfair cycle that can seem impossible to break out of, but the good news is: it is possible to do so.
It’s common knowledge that Americans are stressed. The 2015 report by the American Psychological Association shows that stress levels continue to increase every year, with women reporting slightly higher levels than men.77 Interestingly, the report indicated that Americans grow more aware every year of the negative effects stress can have on the body and mind; nearly a third of respondents reported that stress has a “strong or very strong” impact on their physical and mental health.
It’s clear that stress is a constant, negative presence in most of our lives. What is less clear is how to cope with stress and effectively restore our adrenal glands to full health. Simple tests can reveal when adrenal glands are unhealthy. Normally the size of walnuts, unhealthy adrenal glands are smaller and shrunken-looking. Shrunken adrenal glands are a signal from the body saying that there is a deficiency in important vitamin and minerals. When the deficiency goes unaddressed, patterns of symptoms begin to occur.
The Adrenal Hormone Symptom Pattern
An example of a person—let’s call her Brianna—living with shrunken adrenal glands might look like this: Brianna wakes up in the morning exhausted. Her husband greets her affectionately, but she feels disinterested and instead shuffles into the kitchen to get as much coffee into her system as possible. Before heading to work, she notices that she’s starting to break out a little, and wonders tiredly: “Wasn’t this supposed to stop after puberty?”
She either doesn’t eat breakfast or is drawn to foods high in fat and sugar, such as a pastry from the Starbucks drive-through. The adrenal gland, struggling to process the rush of caffeine, sugar, and fat, signals its distress via the mid-morning “crash” that she experiences just before lunch. The cycle continues throughout the day, interspersed with food cravings (in particular, those of the salty variety). At night, Brianna experiences disrupted sleep patterns such as waking up and being unable to fall back asleep. The next day, she does it all over again.
How did Brianna reach this point?
It all starts when you ignore your adrenal symptoms, which is direct feedback from your body that can cause you to feel alert and content or exhausted and frazzled. Ignoring this feedback can manifest in day-to-day life. In an article for Psychology Today, Annie McKee writes that stress often causes us to “metaphorically (and sometimes literally) shut the office door to keep demands and people at bay.”78 We do the same thing to our bodies, putting off dealing with the actual problems and instead attempting—and failing—to smother the symptoms.
Tracking adrenal symptom patterns gives us an idea of how well the gland is functioning and communicating with other glands in the endocrine system.
An unhealthy, shrunken adrenal gland will be unable to regulate healthy levels of glucocorticoids such as:
Cortisol: a stress hormone responsible for balancing blood sugar
DHEA: a natural steroid-hormone that controls body odor, hair and skin oiliness, and acne
Progesterone: another natural steroid hormone that regulates weight, sex drive, mood, and menstrual symptoms in women.[image: ]
Adrenal Hormone Body Type
This is the most common body type. The Adrenal body type experiences weight gain in their midsection, face, and may also develop a “buffalo hump” of excess skin on their upper back/neck area. A study conducted by doctors in Portugal looked at the direct effects of stress on adrenocortical function and found that that: “In conditions of chronic stress the adrenal cortex undergoes an adaptation that allows the hypersecretion of glucocorticoids to occur…” This means that over time, the adrenal cortex will secrete more and more hormones in response to stress.
This causes symptoms to worsen
In particular, Adrenal-types secrete too much of the hormone cortisol. Cortisol is catabolic, meaning it tears down tissue and results in an aesthetically unpleasing, saggy look to the body. Adrenal types also have ligament issues, take longer to respond to chiropractic adjustments, and experience reoccurring muscle injuries.
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Summary
Now I understand we are all stressed, but we deserve to be less stressed. The health of the adrenal glands is hugely important to individual health because they regulate stress and blood sugar. However, they can be hard to monitor until symptoms are obvious.
Common symptoms of unhealthy adrenal glands include:
Lethargy
Insomnia
Food and caffeine cravings
Weight loss/gain
All of these symptoms take a toll over time, but it is possible to restore adrenal glands to full health.
5 Steps to Balancing Hormones Naturally
Your weight issues are not your fault, even if it’s been a lifelong struggle. Hormone imbalance is one of the primary reasons for weight gain or weight loss and is one of the reasons you may be experiencing common symptoms and conditions such as fatigue, blood sugar problems, anxiety, or depression. The link between hormone imbalance and these conditions is so strong that you would think we would all be fluent in how our hormones function, but it remains a mystery to most of us. Unraveling the complexities of hormone imbalance may seem like a challenge at first but understanding them, however, is paramount in balancing your body and unleashing your true health potential. Let’s start by understanding the endocrine system which is responsible for hormone function.
Where Do Hormones Come From?
Hormones are actually chemical messengers that are created by your endocrine glands. Your endocrine system is a combination of organs that are in charge of sexual function, stress, and anxiety, just to name a few. Over time, due to our stressful lifestyle, habits and nutrient deficiencies, these organs become stressed out, tired, sick, and injured.
Are Your Hormones Communicating?
Have you ever talked to someone who couldn’t hear you because they had earbuds (headphones) in? Your endocrine glands (hormone producers) experience the same thing! Your glands will over or underproduce hormones when they cannot receive the signals. This is typically because the hormone-producing glands are tired, sick, or injured, and hormone receptors cannot receive or interpret signals. Here is a list of the top 12 hormone symptoms.
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The Hormone Symptom Patterns
Your symptom patterns are the key to understanding which glands are malfunctioning and need support. This support can be in the form of functional foods, herbs, enzymes, minerals, and/or vitamins. Symptom patterns tend to be physical in nature like skin problems, weight gain, weight loss, lines on neck, hair loss, PMS, ED along with emotional symptoms such as anger, anxiety, sorrow, or depression. You may also have cravings for caffeine, salt, fat, or sugar.
Hormone-Body Composition Connection
Hormone types are classified by a combination of body composition (overweight / underweight) and hormone symptom patterns (physical, emotional, or food cravings). There are 5 main hormone types: Pituitary, Adrenal, Thyroid, Ovary (female reproductive organs), Gonadal (male reproductive organs), and Liver. Since we are all so different physically and chemically, we each have our own hormone imbalance pattern. Though you may have many performance gaps in many hormone glands, there is usually one dominant dysfunctional gland.
Once you understand your symptom patterns, it can be difficult to know where to start. This is where health questionnaires and lab testing is very helpful in understanding where your specific hormones are imbalanced. We have a free hormone health questionnaire along with a personalized report that will help you to not only understand what hormone body type you are, but also which lab tests would be most useful in re-balancing your body.
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Hormone Lab Testing Overview
There are many test choices and laboratory companies to choose from in order to analyze your hormone levels once you get a better understanding of your hormone body type. This can be very helpful to pinpoint which gland you should support first. Our office uses a combination of either urine, saliva, and/or blood to understand how to best support your body’s specific hormone function and which glands to rest and nourish first.
Urine Hormone Testing
The new kid on the block (since the 1980’s) is looking at hormones through the urine. You still get to see the free hormones, but you also get to see their metabolites. This can be very useful when putting together a dietary and supplement plan to support the underlying organs. According to an article published in the Townsend Letter, “It is well-established that certain estrogen metabolites are ‘good’ estrogens, having a protective effect on estrogen-sensitive tissues. Other metabolites are known to have more carcinogenic effects.” Urine is also pretty easy to collect. This has become the hormone test of choice for a majority of cases.
Saliva Hormone Testing
Saliva, up to a few years ago, was the gold standard in hormone testing. It is still excellent because it measures the free hormone levels and is very accurate. We still like to use the 11 sample saliva test for our fertility cases because of the usefulness of the graphs to represent the entire cycle, but it falls short for two big reasons. First, you can get a thing called occult blood in the sample that can ruin the test. This is when the gums bleed (typically from brushing your teeth or flossing and you have a Vitamin C deficiency) and when you spit into the plastic vial it will invalidate your test. The second shortcoming of this test is it does not measure the metabolites.
Blood Hormone Testing
We like to start everyone with a basic wellness panel to understand blood sugar issues (Hemoglobin A1c) and Fasting Blood Glucose. We also like to get some baseline numbers on how your liver is doing by looking at AST and ALT. General thyroid markers (T3, T4, rT3, and rT4) are also looked at in our basic wellness panel . Blood is not the best way to get a look at all the hormones because blood TYPICALLY looks at the bound hormone (to a protein) and not the free hormone (what your body uses). You can get free hormone values, but it is not as cost efficient and accurate. It is up to the lab of choice to understand thyroid function. We use an 11 sample blood test to dig deeper into thyroid function.
Your next step is to take the quiz to see what test options are right for you. You can take this online health quiz at BurlisonClinic.com or https://burlisonclinic.com/hormone-type-questionnaire/ to find out your hormone body type.
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You can take your quiz at BurlisonClinic.com
60 Roles of the gut in the metabolic syndrome: an overview. Fändriks L
61 Gut Microbiota, Bacterial Translocation, and Interactions with Diet: Pathophysiological Links between Major Depressive Disorder and Non-Communicable Medical Comorbidities; Slyepchenko A1, Maes M, Jacka FN, Köhler CA, Barichello T, McIntyre RS, Berk M, Grande I, Foster JA, Vieta E, Carvalho AF.
62 Echocardiogram changes following parathyroidectomy for primary hyperparathyroidism: A systematic review and meta-analysis; Best CAE, Krishnan R, Malvankar-Mehta MS, MacNeil SD.
63 [Endocrinological changes in pre- and postmenopause]; von Holst T
64 Hormone-dependent gynaecological disorders: a pathophysiological perspective for appropriate treatment; Petraglia F, Musacchio C, Luisi S, De Leo V.
65 Chronic hyperandrogenemia in the presence and absence of a western-style diet impairs ovarian and uterine structure/function in young adult rhesus monkeys; Bishop CV, Mishler EC, Takahashi DL, Reiter TE, Bond KR, True CA, Slayden OD, Stouffer RL
66 Hyperglycemia Impairs Neutrophil Mobilization Leading to Enhanced Metastatic Seeding; Fainsod-Levi T, Gershkovitz M, Völs S, Kumar S, Khawaled S, Sagiv JY, Sionov RV, Grunewald M, Keshet E, Granot Z
67 The Emerging Role of Complement c3 as A Biomarker of Insulin Resistance and Cardiometabolic Diseases: Preclinical and Clinical Evidence; Ursini F, Abenavoli L
68 delta 5-3 beta-hydroxysteroid dehydrogenase activity in sebaceous glands of scalp in male-pattern baldness; Sawaya ME, Honig LS, Garland LD, Hsia SL.
69 Dangers of Excess Estrogen In the Aging Male; William Faloon
70 Group 2: Adrenal insufficiency: screening methods and confirmation of diagnosis; Chanson P, Guignat L, Goichot B, Chabre O, Boustani DS, Reynaud R, Simon D, Tabarin A, Gruson D, Reznik Y, Raffin Sanson ML
71 Vitamin A deficiency in chronic cholestatic liver disease: Is vitamin A therapy beneficial? Freund C, Gotthardt DN
72 https://secure.proactrx.com/media/files/August_Newsletter_-_hypothyroid.pdf
73 Is low iodine a risk factor for cardiovascular disease in Americans without thyroid dysfunction? Findings from NHANES; Tran HV, Erskine NA, Kiefe CI, Barton BA, Lapane KL, Do VTH, Goldberg RJ
74 Fetal brain progenitor cells transdifferentiate to fates outside the nervous system; U HS, Alilain W, Saljooque F.
75 Early recognition of aggressive pituitary adenomas: a single-centre experience; Ceccato F, Regazzo D, Barbot M, Denaro L, Emanuelli E, Borsetto D, Rolma G, Alessio L, Gardiman MP, Lombardi G, Albiger N, D’Avella D, Scaroni C
76 Screening of congenital hypothyroidism in preterm, low birth weight and very low birth weight neonates: A systematic review; Hashemipour M, Hovsepian S, Ansari A, Keikha M, Khalighinejad P, Niknam N
77 http://www.apa.org/pubs/info/reports/2015-report.pdf
78 Stress: The Happiness Killer at Work
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